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Knowledge, attitudes and practices regarding diabetic nephropathy among patients with diabetes in Shanghai, China: a

Chen Ji¹, Chunyang Zhang²

¹General Practice, Changshou Street Community Health Service Hospital, Shanghai, China.

|July 10, 2026

Abstract

Objectives:

This study aims to investigate the knowledge, attitudes and practices (KAP) regarding diabetic nephropathy among patients with diabetes.

Design:

A cross-sectional survey was conducted.

Setting:

The survey was administered in a clinical setting.

Participants:

A total of 410 patients with diabetes completed the questionnaires, with 215 (52.44%) identified as female and 262 (63.9%) not diagnosed with diabetic nephropathy.

Interventions:

Participants provided demographic information and answered questions assessing their KAP through a structured questionnaire.

Primary And Secondary Outcome Measures:

The primary outcomes measured included knowledge scores, attitude scores and practice scores concerning diabetic nephropathy.

Results:

The mean scores for KAP were 5.63±3.14, 16.82±5.21 and 15.03±5.89, respectively. Multivariate analysis showed that female gender (OR=0.57, 95% CI 0.35 to 0.92, p=0.024), monthly per capita income exceeding ¥10 000 (OR=3.96, 95% CI 1.38 to 11.30, p=0.011) and type 1 diabetes (OR=2.52, 95% CI 1.10 to 5.74, p=0.028) were independently associated with adequate knowledge. Knowledge score (OR=1.39, 95% CI 1.26 to 1.54, p<0.001) and diabetic retinopathy (OR=0.37, 95% CI 0.18 to 0.78, p=0.009) were associated with attitude. Proactive practice was associated with knowledge score (OR=1.32, 95% CI 1.17 to 1.50, p<0.001), attitude score (OR=1.28, 95% CI 1.17 to 1.40, p<0.001) and income level (p<0.05). Proactive practice was associated with knowledge score (OR=1.32, 95% CI 1.17 to 1.50, p<0.001), attitude score (OR=1.28, 95% CI 1.17 to 1.40, p<0.001) and monthly per capita income, including ¥2000-4999 (OR=5.09, 95% CI 1.57 to 16.40, p=0.007), ¥5000-9999 (OR=4.57, 95% CI 1.35 to 15.40, p=0.014) and ≥¥10 000 (OR=5.49, 95% CI 1.31 to 22.90, p=0.019).

Conclusions:

Patients with diabetes demonstrated insufficient knowledge, unfavourable attitudes and passive practices regarding diabetic nephropathy. These findings highlight the need for targeted interventions and educational programmes to enhance awareness and encourage proactive management among this population.

Keywords:

Attitude DIABETES & ENDOCRINOLOGY Diabetic nephropathy & vascular disease Diabetic neuropathy Knowledge

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